Update on Mental Health Clinic Consolidation

February 24, 2012

Dear Neighbor,

I am writing to update you on the status of the City of Chicago’s plan to consolidate the City’s mental health centers from twelve to six clinics. The consolidation plan was made a part of the Mayor’s proposed 2012 budget, which was approved unanimously by the City Council last November.

Though I voted for the proposed budget, I understood the fears and concerns expressed by many of the clients of those health clinics and their advocates. Those struggling with mental illness are among our city’s most vulnerable citizens. All the City’s mental health clients will continue to receive care, but some clients will have to visit a new clinic. Some will lose their current therapist, with whom they have developed a relationship of trust, and will have to build a new relationship with a new therapist.

These changes are not to be taken lightly and I pledged to closely monitor the consolidation as it was implemented to ensure it was done smoothly and with sensitivity and that all the City’s mental health clinic clients continue to receive services at the same or greater level.

Since the budget vote, I have hosted two meetings at my ward office with clients of the mental health clinics, their advocates and Department of Public Health Commissioner Bechara Choucair and his staff. Commissioner Choucair explained the rationale for the consolidation and the steps that will be taken to ensure that all clinic clients will continue to receive services. He has pledged to meet with us on a regular basis as the consolidation moves forward. I very much appreciate his openness, accessibility and transparency.

Below is a report of what I have learned:

The Consolidation Plan

The Department of Public Health currently operates 12 clinics that provide mental health services to over 3,400 clients. Beginning in April, the department plans to close six of the clinics, including the Northtown Rogers Park Mental Health Center located on Howard Street.

Commissioner Choucair assured me and the others present at the meetings in my office that even though six clinics are closing, all 3,400 of the City’s clients will continue to receive mental health services at the same or enhanced levels. Approximately 80 percent of the City’s existing clients (over 2,600 mostly uninsured clients) will continue to receive services from a City mental health clinic. Though the City will continue to have capacity to serve 1,000 insured clients, most of the clients with insurance (730 clients, or approximately 20 percent of the current clients) will be served by community mental health providers who often can provide a broader range of services more efficiently.

The six remaining City mental health clinics will be fully staffed and a “quality team” will monitor the transition of all the City’s mental health clients for at least 90 days to ensure they are continuing to receive care.

Uninsured clients who currently receive treatment at the Northtown Rogers Park Mental Health Center will continue to receive services at the North River Mental Health Center located at 5801 N. Pulaski. Clients who carry Medicaid, Medicare, or private insurance will receive care through one of several private providers in our area (e.g., Thresholds, Trilogy, Community Counseling Centers of Chicago).

The Rationale for the Consolidation Plan

According to Commissioner Choucair, these changes have been in the works long before the Mayor proposed his budget. They are the result of a series of discussions with mental health consumers, advocates, professionals and providers and were not dictated by the Mayor or his budget office.

As Commissioner Choucair explains it, the consolidation will allow the City to focus care on its uninsured clients. Recent changes to Medicaid reimbursement rules give private community mental health providers the ability to treat more clients with Medicaid/Medicare. Those providers are often able to provide those insured clients a broader range of services at a lower cost than the City health clinics can provide. Consequently, it made sense to turn the responsibility of caring for insured patients over to the private providers.

The uninsured clients, on the other hand, have fewer options than those with insurance and are often the most vulnerable. The consolidation will enable the Department to increase the number of psychiatrists on staff to treat those who need a higher level of care and allow the clinical therapists to spend more time with clients and less time performing administrative tasks.

Currently, many of the clinics lack administrative staff to answer phones, perform data entry and other routine tasks. Instead, therapists are forced to spend their time performing administrative functions rather than counseling patients. Consolidation into six clinics will insure full staffing at each of the remaining clinics and allow the therapists to devote their full time and energy to providing therapy.

The Northtown Rogers Park Mental Health Center was slated for closure because, unlike the North River Center, it is not large enough to accommodate additional personnel or patients. Moreover, our area has several high-quality private providers that are conveniently located for Northtown Rogers Park’s insured clients.

Implementation of the Consolidation Plan

Two of the health clinics, including the Northtown Rogers Park clinic, will close on April 9th. The remaining four will close on April 30th. Commissioner Couchair assured us that steps will be undertaken to ensure a smooth transition for those who will be changing facility locations.

Each client’s therapist will make sure their first appointment is scheduled and their transition is monitored. A “Quality Team” will monitor each client for at least 90 days, or longer if necessary, to ensure they are continuing to receive the care they need. The Department will also provide some transportation assistance to patients changing facility locations.

Commissioner Choucair promised to meet with me and the clients and activists again as the process moves forward and urged us to contact him at the first sign that some clients may be “falling through the cracks.” My staff and I will continue to closely monitor the progress of the consolidation to make sure that the quality and continuity of care is not compromised. And I will report to you again as the process moves forward.

For more information on the consolidation, including answers to frequently asked questions, CLICK HERE.